OnabotulinumtoxinA in overactive bladder: Evidence-based consensus recommendations

Autores de IIS La Fe

• Salvador Arlandis Guzmán

  Autor

Participantes ajenos a IIS La Fe

• Jimenez-Cidre, MA
• Grp Espanol Uso Toxina Botulinica

Grupos

• Urología

  Leader

  Francisco Boronat Tormo

Abstract

Objective: To offer a set of useful recommendations for urologists who are starting to provide treatment of overactive bladders with onabotulinumtoxinA. Methods: A literature search to December 2013 was conducted, as well as a subsequent critical reading of the selected publications. The coordinators prepared a document that was submitted for review by the members of the Spanish Group for the use of Botulinum Toxin in Urology. Results: The expert group considered that onabotulinumtoxinA may be used for overactive bladder syndrome with urinary urge incontinence secondary to neurogenic or idiopathic detrusor overactivity for patients for whom conservative treatment and first-line medical treatment has failed, is not tolerated or is contraindicated. Treatment in most cases was performed with local intravesical anesthesia, although it can also be performed under epidural or general anesthesia. Patients must be informed of the possibility of requiring self-catheterization or temporary catheterization. Clinicians should ensure that the patients are capable of performing this catheterization before the treatment is conducted. Patients must also be informed of the need for antibiotic prophylaxis to reduce the risk of urinary tract infections. At least 2 follow-up visits are recommended: the first at days 7-14 after the injection and the second at 2-3 months. Reinjection is indicated when the effect of the treatment decreases. Conclusion: These guidelines can help clinicians in their daily decisions and limit the potential risks associated with the incorrect use of the drug. (C) 2015 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Botulinum toxin; Overactive idiopathic bladder; Overactive neurogenic bladder, Botox (R); Urinary urge incontinence; Detrusor overactivity